CareFirst HDHP — what am I missing?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I've had it for the past 2 years and am switching to GEHA standard as I am hoping for a more straightforward plan.

I felt like I've had to pay a lot out of pocket even after the deductible. Some of it could be because I had imaging done and the radiologist ended up being out of network which is annoying. For example, I got an MRI at Sibley and the imaging was covered but not the radiologist's fees. A mammogram that was diagnostic not preventive was not covered.

I’m the OP of this thread, and this is very useful feedback. I’m pretty vigilant about making sure everything is in network (I hardly visit the doctor, so it’s usually not a big deal for me), but I’ll definitely emphasize for my husband the importance of using only in-network labs, etc. Thanks, PP.

When you have any procedure it is basically impossible to know if your provider will be in the plan (anesthesia, imaging, on and on). Is out of network much more expensive for HDHP than Standard? This is probably why when you are on an HMO with strict in network requirements, they send you to an HMO hospital (Kaiser),

[Anonymous]

You can appeal this because you didn't actually have a choice of an in-network provider.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I've had it for the past 2 years and am switching to GEHA standard as I am hoping for a more straightforward plan.

I felt like I've had to pay a lot out of pocket even after the deductible. Some of it could be because I had imaging done and the radiologist ended up being out of network which is annoying. For example, I got an MRI at Sibley and the imaging was covered but not the radiologist's fees. A mammogram that was diagnostic not preventive was not covered.

I’m the OP of this thread, and this is very useful feedback. I’m pretty vigilant about making sure everything is in network (I hardly visit the doctor, so it’s usually not a big deal for me), but I’ll definitely emphasize for my husband the importance of using only in-network labs, etc. Thanks, PP.

When you have any procedure it is basically impossible to know if your provider will be in the plan (anesthesia, imaging, on and on). Is out of network much more expensive for HDHP than Standard? This is probably why when you are on an HMO with strict in network requirements, they send you to an HMO hospital (Kaiser),

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I've had it for the past 2 years and am switching to GEHA standard as I am hoping for a more straightforward plan.

I felt like I've had to pay a lot out of pocket even after the deductible. Some of it could be because I had imaging done and the radiologist ended up being out of network which is annoying. For example, I got an MRI at Sibley and the imaging was covered but not the radiologist's fees. A mammogram that was diagnostic not preventive was not covered.

I’m the OP of this thread, and this is very useful feedback. I’m pretty vigilant about making sure everything is in network (I hardly visit the doctor, so it’s usually not a big deal for me), but I’ll definitely emphasize for my husband the importance of using only in-network labs, etc. Thanks, PP.

When you have any procedure it is basically impossible to know if your provider will be in the plan (anesthesia, imaging, on and on). Is out of network much more expensive for HDHP than Standard? This is probably why when you are on an HMO with strict in network requirements, they send you to an HMO hospital (Kaiser),

The coverage (whether something is in or out) should be the same. The deductible/out-of-pocket will be higher with HDHP (because your premiums are a lot lower). Once you pass that threshold, co-pays will be the same (e.g. 20%).